Provider Demographics
NPI:1205047602
Name:SWANSON, JOANNE TERRY (MSW)
Entity type:Individual
Prefix:MS
First Name:JOANNE
Middle Name:TERRY
Last Name:SWANSON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 WATERFORD LN
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78628-6905
Mailing Address - Country:US
Mailing Address - Phone:413-687-4057
Mailing Address - Fax:
Practice Address - Street 1:133 WATERFORD LN
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78628-6905
Practice Address - Country:US
Practice Address - Phone:413-687-4057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1160851041C0700X
TX1073081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical